Is There Any Light in the Tunnel? On the Drawbacks of the Roma Educational Integration in Bulgaria

The main objective of this paper is to identify the issues, which have led to Roma exclusion from the mainstream education. The first part of the paper is focused on data, correlating unequal educational opportunities and the ethnicity factor. The text presents an insight into the widely argued Roma dropout phenomenon. Different sets of reasons for dropping out from school are being discussed, i.e. educational, ethnic and cultural, economic, and family reasons. In addition, the article reflects on the retrograde beliefs of the majority population as a prerequisite for Roma reluctance towards continuing education. Moreover, the article puts forward a review on the most recent key policy measures for equal educational opportunities, targeting the Roma. Various aspects of adopted policy interventions for stimulating educational inclusion are illustrated, and supplemented by a critical analysis. The authors conclude that the required strategic actions, targeting educational equity for marginalized social groups, such as the Roma, have been indeed formulated by the stakeholders; yet, certain shortcomings have been noticed and these are primarily linked to the practical implementation of the national documents into real actions

Haberlea rhodopensis (Friv.) reduces chromosomal aberrations in whole body irradiated rabbits

Radioprotective effect of ethanolic extract of Haberlea rhodopensis have been studied by examining chromosome aberration in irradiated rabbits. Healthy adult New Zeland rabbits were injected intramuscularly (im) with 120 mg/kg body weight before and after irradiation or with double distilled water (DDW). They were exposed to whole body irradiation of 2.0 Gy gamma rays. After 24 h chromosomal aberrations were studied in the peripheral blood lymphocytes. Radiation (2.0 Gy) increased the number of aberrant cells from less than 3% in controls to almost 25%. Treatment with the total extract of Haberlea rhodopensis (HR) before and after irradiation resulted in a significant reduction in the percentage of aberrant metaphases as well as in the different types of aberration scored. Our results proved the ameliorating role of HR against radiation-induced chromosomal aberrations in rabbits. Further experimental studies using different cytogenetic and molecular biomarkers  are needed to clarify the exact mechanisms of radioprotective action of the HR extract

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

FAMILY OF A MENTALLY RETARDED CHILD-NEW FUNCTIONS IN A CONDITIONS OF TRANSITION

In this paper specific knowledge by the research of the state of the family of mentally retarded child in present conditions of transition in Bulgaria is presented.In a very picturesque and overwhelming review are presented a lot of questions and problems of families on a social, economic, health, psychological and valuable aspect, with numerous consequences on the existence of the families and mentally retarded children that the transition leaves under the present existence of human

Predictors and Prognostic Indices for the Clinical Course and the Effect of Treating Patients with Rheumatoid Arthritis // Предиктори и прогностични индекси за клиничното протичане и ефекта от лечение при болни от ревматоиден артрит

Rheumatoid arthritis (RA) is often considered unpredictable. Establishing markers that can be used to detect patients with a more aggressive course of the disease and a worse prognosis for treatment outcomes would allow for an adequate choice of therapy depending on the activity of the disease and the expected progression. Analysis of the scientific literature shows that at this stage, there is a lack of a well-functioning and reliable tool for everyday clinical practice that can predict the course of rheumatoid arthritis, the likelihood of rapid x-ray progression, and the expected effect of the onset of treatment. The study aims to attempt to determine the important factors for the prognosis of the severity of the disease and to evaluate the effect of the applied treatment in patients with rheumatoid arthritis as well as to develop a prediction model. A total of 67 patients with rheumatoid arthritis, aged 56.43g (26 ± 77), participated in the study. Of these, 17 are male (25.4%), and 50 are women (74.6%). Patients were treated with methotrexate and monitored for 1 year. At the beginning and end of the follow-up period, the following indicators were studied and traced: C-reactive protein, IgM, IgG and IgA isotypes, aCCP antibodies, clinical indices (total number of swollen and painful joints) for the activity of the disease according to the physician/patient via visual analogue scale (VAS) and DAS28-CRP). To assess the radiographic progression of the disease, images of conventional X-rays of hands were compared using the Simple Erosion Narrowing Score method. The statistical processing was done with SPSS v20 software. Identifying prognostic factors allows the development of matrix models to be applied in assessing the risk of not responding to treatment and the rapid progression of the disease. Patients with a more aggressive disease can be clearly defined through these models, and the disease can influence possible outcomes.Протичането на ревматоидния артрит (РА) често се определя като непредсказуемо. Установяването на маркери, които могат да бъдат използвани за откриване на пациентите с по-агресивен ход на заболяването и по-лоша прогноза за изхода от провежданото лечение, биха дали възможност за адекватен избор на терапия в зависимост от активността на заболяването и очакваната прогресия. Анализът на научната литература показва, че на този етап липсва достатъчно добре работещ и надежден инструмент за ежедневната клинична практика, с който да може да се прогнозира хода на ревматоидния артрит, вероятността от бърза рентгенографска прогресия и очаквания ефект от стартираното лечение. Целта на проведеното проучване е да се направи опит за определяне на важните фактори за прогнозиране на тежестта на заболяването и за оценка на ефекта от прилаганото лечение при пациенти с ревматоиден артрит, както и за разработване на модел за прогнозиране. В проучването са участвали общо 67 пациента с ревматоиден артрит на средна възраст от 56,43г (26±77г.). От тях 17 са мъже (25,4%) и 50 са жени (74,6%). Пациентите са лекувани с метотрексат и наблюдавани за период от 1 година. В началото и в края на проследявания период бяха изследвани и проследени следните показатели – С-реактивен протеин, RF с изотипове IgM, IgG и IgA, аCCP антитела, клинични показатели (общ брой оточни и болезнени стави), индекси за болестната активност (глобална оценка за активността на заболяването според лекаря/пациента чрез визуално аналогова скала (VAS) и DAS28-CRP). За оценка на рентгенографската прогресия на заболяването бяха сравнявани изображения от конвенционална рентгенография на китки, длани и пръсти оценявани чрез метода на Simple Erosion Narrowing Score. Статистическата обработка е направена с програмен продукт SPSS v20.Идентифицирането на прогностичните фактори дава възможност за изработване на матрични модели, които да се приложат в практиката за оценка на риска от неповлияване от лечение и бърза прогресия на заболяването. Чрез тези модели може ясно да се дефинират болните с по-агресивна болест и да се очертаят възможностите за въздействие върху заболяването

Is There Any Light in the Tunnel? On the Drawbacks of Roma Educational Integration in Bulgaria

The main objective of this paper is to identify the issues, which have led to Roma exclusion from the mainstream education. The first part of the paper is focused on data, correlating unequal educational opportunities and the ethnicity factor. The text presents an insight into the widely argued Roma dropout phenomenon. Different sets of reasons for dropping out from school are being discussed, i.e. educational, ethnic and cultural, economic, and family reasons. In addition, the article reflects on the retrograde beliefs of the majority population as a prerequisite for Roma reluctance towards continuing education. Moreover, the article puts forward a review on the most recent key policy measures for equal educational opportunities, targeting the Roma. Various aspects of adopted policy interventions for stimulating educational inclusion are illustrated, and supplemented by a critical analysis. The authors conclude that the required strategic actions, targeting educational equity for marginalized social groups, such as the Roma, have been indeed formulated by the stakeholders; yet, certain shortcomings have been noticed and these are primarily linked to the practical implementation of the national documents into real actions

HIGHER EDUCATION IN BULGARIAN CONTEXT: PECULIARITIES AND CHALLENGES

The objective of this article is to illustrate the issues and challenges which the higher education system in Bulgaria faces, with a particular accent on the phenomenon “education per kilogram”. The latter describes, in a popular language, the up-scaling of the university graduation, related to the mass proliferation of the higher education institutions (HEIs), the facilitated access to enrolment through paid tuitions, etc. The big quantity of HEIs in the country is in a mismatch with the low percentage of GDP which the government dedicates to education. The number of HEIs is also disproportionate against its population size - 54 HEIs in Bulgaria for population of 7.2 million. The research methodology includes a desktop study based on national statistical data and data from the governmentally-supported university rating system. An empirical survey, conducted among 250 tertiary education students enrolled in four Bulgarian universities, is a valuable contribution towards disclosing the pros and cons of the teaching practices in the tertiary education in the country. The first chapter describes at large the “education per kilogram” issue with regard to its possible origins, variations and consequences for the misbalance of labour market demand for certain qualifications and the universities supplies of qualified individuals. The second chapter reveals a comparative analysis by professional fields possible through the Ministry of Education and Science’s university rating system, i.e. students’ preferences for disciplines, universities and professions; the graduates’ professional fulfilment and how the income of the recent diploma-holders is a function of attending a particular HEI. The third chapter presents a sociological survey conducted among students in four Bulgarian universities which demonstrates learners’ attitudes towards various aspects of training, teaching methods and involvement in research assignments in the context of tertiary education